Stroke in children
What marks a stroke in children?
Like adults, strokes in children are also circulatory disorders of the brain. As a rule, a blood clot in the cerebral arteries is the cause. Such clots cause ischemic loss of nerve tissue. The brain or parts of the brain are no longer supplied with sufficient oxygen and nerve tissue dies. Around 500 children and adolescents under the age of 18 suffer a stroke in Germany every year.
The number of unreported cases is estimated higher because doctors rarely think of a stroke in children. Pediatric stroke occurs in one third of all cases during childbirth and is then caused by natonal stress. Some children also experience prenatal strokes. So you are still affected in the womb of a stroke.
In adults, the causes of stroke are often calcified or narrowed arteries. In childhood, other causes are usually responsible for the circulatory disorder of the brain. Infections such as chickenpox are associated with the risk of stroke at a young age. Thus, the circulatory disorder in preschool children is most often due to an infection.
At the beginning of puberty taking the birth control pill in girls may increase the risk of stroke. Smoking may also increase the risk of stroke during this time. In some cases, the cerebral arteries are injured by jerky movements, such as during sports or roller coaster rides. This phenomenon affects young people in particular. Children with heart disease, high blood pressure, obesity or narrowed arteries are generally at higher risk for stroke.
Symptoms, complaints & signs
Severe headaches are the symptom that parents most often seek medical attention with their children after a stroke. Strokes can also manifest in generalized muscle weakness of a particular body half, causing twitching on one side of the body or triggering an unsteady gait. Difficulty in swallowing, indistinct speech, numbness and blurred vision are warning signs that may indicate a stroke.
In extreme cases even hemiplegia occurs. Above all, the prenatal and birth form of stroke rarely shows prompt symptoms. Affected children may use one side of the body less often than the other during the first attempts at gripping. Even when crawling a body half may be less used. However, there are several months between prenatal and birth strokes between actual stroke and symptoms.
Diagnosis & disease course
Especially with younger children, the diagnosis of stroke is difficult. This is especially true because younger patients can hardly describe their complaints in their medical history. For diagnostics, motion tests and eye tests are performed. Blood tests can also be used as a diagnostic tool. To detect narrowing of the cerebral arteries, sonography of the carotid arteries is performed.
Shortly after a stroke by blood clots show in the veins also bulges, which have been caused by the flushed clot. To identify affected brain regions, an imaging technique such as CT or MRI is used. If there are lesions in the tissue of the brain, then these lesions may also have inflammatory causes.
To prevent inflammation and bacterial infections, CSF may be required. The prognosis is more favorable in pediatric stroke than in stroke in adulthood.
Since children can not be asked about their complaints like adults, it is difficult to diagnose a stroke in very young patients. In general, the prognosis in children is more favorable than in adults, but it must still be expected with a number of problems.
For example, a stroke can impair the development of motor skills and lead to severe movement disorders. In these cases, an often lengthy combination of physiotherapeutic and occupational therapy measures is applied to the affected child, which often can only be reconciled with the professional obligations of the parents and the daily routine of the family.
Speech and swallowing disorders are also not uncommon complications that develop after a stroke in children and then require a logopedic treatment. The more serious complications that can be expected include neuropsychological side effects that interfere with the patient's behavior and cognitive abilities.
Although adequate treatment can be started in good time, these disorders can be corrected very often, but here, too, sufferers have to prepare themselves for a lengthy course of treatment. In addition, permanent reduction of cognitive abilities is not excluded. These often only become apparent during school enrollment when children notice a stroke due to lack of concentration and learning difficulties. These children then need special support.
When should you go to the doctor?
Fortunately, it does not happen that often, but a stroke in children should always be treated by a doctor. If it is already possible to detect the first symptoms that indicate a stroke, no time must be lost. It must be called immediately an ambulance, who provides first aid. Time plays a big role in a stroke, so call 112 does not hesitate.
The sooner first aid can be given, the better the chances of a complete recovery and recovery. If there is a delay in initial care, permanent damage may be left to the affected person. For this reason, fast first aid is particularly important for a child. Therefore, a doctor should be consulted or called immediately at the first symptoms. This can ensure that a quick and complete recovery can take place.
Treatment & Therapy
The child's stroke is treated depending on the causes and symptoms. Modern therapies for adults are not yet approved for children, such as the lysis treatment. If the stroke has caused movement disorders, physiotherapy treatment is recommended. Thanks to the Bobath concept, the children recapture lost motion sequences.
Occupational therapy can also be helpful in this context. If speech disorders or dysphagia are present, logopedic care is indispensable. In addition, since pediatric strokes often affect children's behavior, an experienced neuropsychologist should also assess cognitive and mental disorders and limitations. Since a child's brain is still developing, regular and long-term training offers a good chance of a full recovery.
The brain of children is much more flexible than the brain of an adult. The nerve tissue is less specialized. Thus, other parts of the brain may possibly be trained to take over the functions of the failed area. In order to prevent another stroke, prophylaxis must be carried out. This prophylaxis must be designed individually for the individual case.
Because after the schooling of affected children often only later effects such as inability to concentrate noticeable, the affected children are usually promoted longer term than adult stroke patients.
A prenatal or natale stroke can hardly be prevented. However, the use of harmful substances during pregnancy can increase the risk because the embryo is exposed to even more stress. After birth, the overall risk of stroke can be estimated using ultrasound and blood tests, so that general risk prevention can be developed for high-risk patients.
After a stroke in a child is a comprehensive aftercare needed. Affected children suffer from extensive complaints that often need to be treated for months and years. The follow-up includes physical therapy, physical examinations and other measures, the extent of which depends on how seriously the child is damaged by the stroke.
As a rule, follow-up care is provided as part of neurological rehabilitation. The treatment of a stroke in children takes place in a special clinic. The stroke care is designed by the pediatrician or the neurologist. Expert follow-up prevents long-term consequences by identifying complications and including them in further therapy.
In affected children there are often serious underlying diseases which must be treated concomitantly with the stroke therapy. The parents should contact the specialist best and discuss the further procedure together with the latter. The GPs have to be intensively involved in the aftercare.
Comprehensive follow-up significantly reduces the risk of another stroke. As part of the aftercare must also change the diet. In addition, the parents must be informed about possible risk factors such as hypertension or elevated cholesterol levels and trained in the use of measuring instruments.
You can do that yourself
A stroke is a life-threatening condition. It is often difficult for the person concerned to handle. The burden is all the greater if the patient is a child. Naturally, this can not adequately react to the situation or seek changes. In the field of self-help, therefore, relatives and parents are usually responsible for making optimizations.
Stressors are to be detected and should, if possible, be completely degraded or significantly minimized. If the life circumstances or experiences of the past are a special burden for the child, improvements should be sought. A harmonious environment, the avoidance of conflicts as well as the requirements of the child are to be examined. Leisure activities, food intake and sleep hygiene should be adapted to the natural needs of a child. If the child has already experienced severe illnesses in the past, it must be examined whether mental health care can be helpful.
The overall situation should be discussed openly and honestly with the child. Wishes and questions of the child are to be considered in everyday life or should be answered truthfully. As the stroke is often associated with long-term discomfort, it is advisable to adapt the design of the daily routine or the free time to the possibilities of the patient.